Kelly Macken-Marble, Chief Executive Officer at Osceola Medical Center

Summary

Becker’s Healthcare Podcast Summary

Episode: Kelly Macken-Marble, Chief Executive Officer at Osceola Medical Center
Release Date: August 1, 2025
Host: Laura Dardo

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1. Introduction

In this engaging episode of the Becker’s Healthcare Podcast, host Laura Dardo welcomes Kelly Macken-Marble, the Chief Executive Officer of Osceola Medical Center. The conversation delves into the innovative initiatives and strategic growth plans that Kelly and her team are implementing in a rural healthcare setting.

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2. Osceola Medical Center Overview

Kelly Macken-Marble begins by introducing herself and providing an overview of Osceola Medical Center. Located in Northwest Wisconsin, just over the Minnesota border and approximately an hour northeast of the Twin Cities, the center is a critical access hospital licensed for 25 beds but currently staffing 18, including labor and delivery.

“Osceola Medical center is located in Northwest Wisconsin… we have a robust primary care offering and a number of surgical and medical specialties.”
[00:35]

The medical center also operates an outpatient rural health clinic, emphasizing comprehensive care for the surrounding community.

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3. Recent Successes and Growth

When discussing recent achievements, Kelly highlights significant growth in both primary care and ambulatory services, noting an impressive 18% year-over-year increase in the ambulatory space. This expansion has naturally led to growth in inpatient services, including surgical volumes and an average daily census.

“We are seeing nice growth and we're working hard to increase our inpatient average daily census and surgical volumes.”
[02:04]

This period of growth has brought challenges, particularly concerning the physical campus's capacity. However, Kelly views these developments as positive milestones for the organization.

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4. Current Focus Areas and Challenges

Kelly outlines the top priorities for Osceola Medical Center:

1. Improving Access to Care: A critical focus is expanding primary care access by increasing the number of providers. The center plans to add nine new providers over the next year, addressing the community's healthcare needs.

2. Campus Expansion: To accommodate growth, a 20,000-square-foot expansion is underway. This expansion will add exam rooms, pharmacy space, and enhancements to the rehab and therapy center, including a new therapy pool.

3. Satellite Clinic Development: Recognizing that approximately 20% of their patient population hails from Minnesota, Osceola Medical Center is establishing a satellite clinic across the state border to better serve these patients.

“We're in the process of a 20,000 square foot expansion… adding a therapy pool as well.”
[03:58]

4. Navigating Policy Changes: The recent Congressional bill introduces uncertainties around Medicaid and eligibility. Kelly emphasizes the importance of preparedness, managing expenses, and staying informed about policy shifts to ensure the center's resilience.

“Everybody in healthcare is a little bit nervous right now related to the new bill that just recently passed in Congress and potential for changes in Medicaid and eligibility.”
[06:41]

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5. Strategic Planning and Preparing for Future Changes

Kelly discusses the strategies employed to navigate the evolving healthcare landscape:

• Expense Management: Even amidst growth, maintaining control over overhead costs is paramount. Efficient resource management ensures sustainability.

• Community Health Needs Assessment: By focusing on data-driven insights, the center prioritizes services that address the most pressing community health issues rather than merely expanding for market share.

• Adaptability: Emphasizing flexibility, Kelly underscores the necessity of staying nimble to respond to market forces and headwinds effectively.

“Making sure that we're not trying to solve for every problem in the community, but what are the services and support the community needs most.”
[07:35]

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6. Opportunities for Future Growth

Looking ahead, Kelly identifies mental health and substance use disorder services as significant areas for expansion. Osceola Medical Center aims to enhance its offerings through both internal development and strategic partnerships.

• Mental Health Services: The center plans to expand mental health services by adding more clinicians and support staff, crucial in addressing the widespread shortage in this area.

• Substance Use Treatment: Initiatives include introducing intensive outpatient treatment programs and collaborating with regional partners who specialize in addiction medicine to avoid duplicating efforts.

“One of our priorities is to always look at who we can partner with, not reinvent the wheel.”
[12:00]

Kelly also highlights the importance of leveraging existing expertise within the organization, such as the role of Dr. David Friends, the Chief Medical Officer, who is board-certified in addiction medicine.

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7. Leadership Insights for Sustaining a Thriving Organization

In discussing leadership priorities for the next five years, Kelly emphasizes several key factors:

• Nimbleness: The ability to quickly adapt to changing circumstances is crucial for survival and growth, especially in a rural healthcare setting where Osceola Medical Center is the primary provider.

• Clear Strategy and Culture: A well-defined strategic plan and a positive organizational culture are essential. Ensuring that employees feel valued leads to better support for the center’s mission, improved patient experiences, and stronger financial health.

• Resource Stewardship: Effective management of resources, both financial and human, is necessary to maintain viability and continue serving the community effectively.

“Being nimble, constantly watching the market forces out there… making sure we've got a really healthy, happy workforce that feels valued.”
[13:47]

Kelly underscores that a motivated and satisfied workforce directly correlates with the organization's success and ability to thrive amidst challenges.

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8. Conclusion

The episode concludes with Laura Dardo expressing gratitude to Kelly Macken-Marble for sharing valuable insights into managing and growing a rural healthcare organization. Kelly's strategic focus on expanding access to care, addressing mental health and substance use challenges, and maintaining a resilient and engaged workforce provides a roadmap for other healthcare leaders navigating similar environments.

“What we need to do differently is important. Making sure we're not trying to solve for every problem in the community, but what are the services and support the community needs most.”
[07:35]

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This comprehensive discussion offers listeners a deep dive into the operational strategies and leadership philosophies that drive success at Osceola Medical Center, highlighting the delicate balance between growth, community needs, and adaptive leadership in the ever-evolving healthcare landscape.

Transcript

[A]

This is Laura Dardo with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Kelly McEn Marble, Chief Executive Officer of Osceola Medical Center. Kelly, it's a pleasure to have you on the podcast today.

[B]

Yeah, thanks so much for having me.

[A]

Well, I'm excited for our conversation because I know there's so much happening in the healthcare space, and particularly you've got some cool and innovative things you're doing at Osceola Medical Center. So I'm looking forward to learning more about just some of the things you're doing, as well as looking into the future. But before we dive in, I'm curious, could you introduce yourself and tell us just a little bit more about the medical center?

[B]

Sure, absolutely. So again, Kelly McEnmarble, CEO here at Osceola Medical Center. I've been a leader in healthcare administration about 30 years or so, and then in this role specifically at Osceola Medical center for the past three years. Osceola Medical center is located in Northwest Wisconsin, which is just over the Minnesota border. We are about a little less than an hour northeast of the Twin Cities. Just to kind of give you a sense of where we're located, we are licensed for 25 beds, so we are a critical access hospital. We also have an outpatient rural health clinic. And today we staff to about 18 beds, including labor and delivery. And as part of the clinic and hospital services, we have a robust primary care offering. And then we have a number of surgical and medical specialties here at the medical center as well.

[A]

Absolutely. That's great to hear and I know especially fascinating to get a sense of how you're navigating being in a rural healthcare setting. A lot happening in that space right now, today. So I'm curious, what's your biggest win or success story from the last year or so?

[B]

Yeah, well, we're in an exciting time, I would say, here in Osceola, where while we are critical access and rural health, I think our proximity to the Twin Cities and a number of large employers certainly help, certainly helps us. We have had really significant growth in primary care and many of our ambulatory areas experiencing about 18% year over year growth in the ambulatory space, which is exciting and, you know, so we're appreciating that. And with that ambulatory growth, of course, that drives significant growth on the inpatient setting as well. So we are seeing nice growth and we're working hard to increase the our inpatient sort of average daily census and surgical volumes. And as I mentioned, along with ambulatory growth in our clinic, seeing nice growth in our ancillaries. So all of that growth is sort of, it's really good and it brings with it a couple challenges with our physical campus and some things like that. But those have been a nice win for the organization. As we hadn't grown, we've been a little bit stuck, but we're seeing a nice growth pattern right now.

[A]

That's great to hear. And I know there's been kind of an industry wide transition for some of that inpatient care to get into the outpatient setting. And so it's really neat to see you seeing growth in both areas, but then also being able to have that ambulatory continued extension to what you're doing. So that's really great to see. When you look at, you know, everything that's happening in the healthcare space, what are the top two to three issues that you're focused on right now? How are you thinking about things as time goes on?

[B]

Yeah, so I, you know, I referenced our growth in the ambulatory setting and improving access to care. It has been a significant focus for us. We in the last last year and this year will have a net increase of providers of nine. So we're growing and you know, as a critical access hospital, part of our mission here is to meet the needs of our community, improve the health of our community. So improving access to care is a big part of that. So hiring new clinicians. And then as I mentioned, part of the good and bad of that is that we are out of space on our campus. We've outgrown our campus. And so we are in the process of a 20,000 square foot expansion. The expansion is specific to adding exam rooms on the primary care side and specialty side, as well as adding additional pharmacy space and adding space in our rehab PTOT center and we'll be adding a therapy pool there as well. So that's exciting. The significant focus of ours, we also will be building a satellite clinic just over the border into Minnesota. Roughly 20% of our patient population comes from Minnesota. And so we'll be adding a clinic there to support that population as well. So lots of growth, a lot of focus on that. I think with that, I would say, you know, everybody in healthcare is a little bit nervous right now related to the new bill that just recently passed in Congress and potential for changes in Medicaid and eligibility. So some focus on that and just making sure that, you know, we're in a good position to handle whatever changes come next. I think if you work in rural health and you work in critical access. You know, there's a few things that are on the budget docket both nationally and at the state level every year, which is things like 340B, which helps us to procure drugs at a lower cost and you know, just also critical access to the structure for cost based reimbursement. So we're always paying attention to the headwinds in healthcare and just making sure that, you know, we'll be able to manage proactively whatever comes next.

[A]

That's fascinating to hear and certainly, you know, no easy solutions to some of those challenges, but great to know that you've got growth, that you've seen some growth and plan in place to continue to expand, especially, especially with more exam rooms and primary care than within pharmacy as well. You know, when you think about all of the kind of shifts and changing both nationally as well as at the local and state level for policies around healthcare and funding and those kinds of things, is there anything that you as a leader have to do differently or thinking about differently over the next year or two to prepare for some of these things to kick in with the budget bill, or are you seeing a lot of traction and movement for what your plan has always been? And so are you just kind of sticking to, sticking to that as time goes forward?

[B]

Yeah, I feel like it is just always being aware of what the possibilities are and preparing for those as much as possible. I think Medicaid is a good example. Of course, in the critical access rural health space, we are primarily governmental payers. Our reimbursement is mostly from governmental payers. So we have to watch that very closely. I think part of that is managing expenses and just making sure that even during a period of growth that, you know, we're managing overhead and, you know, just being good, managing our resources well and good stewards of our resources. So that's part of it. I think it's also making sure that we're paying attention to things like our community health needs assessment and looking specific at the populations that we care for, what are the types of services that are the most needed. So when we talk about growth a little bit different than all my years in sort of the large health system space where, you know, we were more focused on at times market share, you know, growth through, you know, just growth and market share and really being more laser focused on improving the health and well being of our community. And if we focus on that and the types of services that are needed most, you know, that that will serve us well. I think that there are, you know, services that are going to thrive in an environment like this and some that won't. And so just trying to stay really focused on what are the biggest needs in our community and seeing what we can do to support them and meet those needs. Got it.

[A]

That makes a lot of sense. And thank you so much for speaking to such a timely and important topic. Now, in thinking about the future as well, I wanted to ask where you see some of the big opportunities for growth and develop and continued expansion over the next few years.

[B]

Yeah, as we look at improving access to care and again, looking at things like our community health needs assessment, where we get a really good, really good insight, data driven insight into the types of issues members of our community are seeking and where there is poor access to care. And that is, in our area, not unique. I think there's a lot of the country that's in a similar boat is in the mental health and substance use space. There's not enough treatment available for most people looking to access those types of services. So as we look at improving access to care in the primary care space and a lot of our ancillaries and making sure that we've got good and easy access so that, you know, people aren't having to go to the emergency room for care and things like that, that's really good. What we're seeing is we need to expand our mental health service offering and with that add additional clinicians in the substance use treatment space. So right now we're looking at that and, you know, how can we add additional space or service options there? One of the services we're looking to add is intensive outpatient treatment for patients with substance use disorder that need treatment. And looking at different types of partnerships, how can we provide support into the local schools and, you know, some of those types of things. So for us, I think growth opportunity and addition to some of the sort of traditional services that we've been growing, mental health and substance use is treatment support is another area that we're looking at as an opportunity for growth and most importantly, a way to better support our community.

[A]

Absolutely. That's, you know, so fascinating here and great to be able to be, you know, thinking that into the future how you can better support the broader population. And I'm curious, when you're looking at especially mental health services in services for substance use disorder, are you partnering with other organizations to bring more services into the hospital health system or is it really, you know, something that you're building from within?

[B]

I think it's a mix of both. We have hired clinicians. We have a physician, our Chief Medical Officer, Dr. David Friends, who happens to be also board certified in addiction medicine. So we're really fortunate to have him here. And so because of that, we've built, added a nurse practitioner and other support to help with mental health and then also supporting patients who need assistance with substance use. We. We support patients on an inpatient basis that might need detox or withdrawal support. So, you know, we're providing that today ourselves. But I would say as we look at how we go to the next step in the types of support we can provide for these patients, partnership makes a lot of sense. You know, there's a lot of partners in the region that, you know, already have well defined intensive outpatient programs and those kinds of things. So I think one of our priorities is to always look at who we can partner with, not reinvent the wheel, you know, others that are doing it really well. And so we're having those conversations now and looking at, you know, where partnership makes the most sense for us.

[A]

That's really helpful to understand. Thank you so much for going in a little bit deeper there. Now, before I wrap up, I'm curious, what will it take to lead a thriving organization over the next five years? I know it's impossible to see exactly what will happen into the crystal ball, but from your perspective, as you're thinking through leading a hospital, as well as looking at your leadership team, what do you really need in order to make sure you're thriving as the world is changing around you?

[B]

Yeah. One of the things we talk about as a leadership team a lot is just how making sure that we remain nimble, you know, and as I hear concerns about just how rapidly things are changing, I feel like it's been that way during my whole career is things are just always changing. And so being nimble, constantly watching the market forces out there, what are the headwinds? And making sure we're always looking at ways to remain viable, more so in rural health and in. In an area like this, you know, we are. We are the resource. There aren't, you know, five other hospitals, you know, in the market. It's just us. So making sure that we remain viable so that we can serve our community is really important. And I. I think it's probably that way for every hospital. But something I think being nimble, you know, paying attention, watching, always looking at, you know, what we need to do differently is important. Making sure we're not trying to, you know, solve for every problem in the community, but what is. What are the services and support the community needs most? And making sure we focus on those things, making sure we're good stewards of our resources, as always, you know, important. And then I think about making sure we've got just a really clear strategy and plan here that the organization can rally around. And part of remaining viable is having a healthy culture where people want to work and clinicians want to work and, you know, all of those kinds of things, too. I think that often gets, you know, not. Not always looked at as we think about, you know, viability and, you know, the financial outlook is, you know, do we have employees and doctors and nurse practitioners and PAs that, you know, feel valued? And lots of studies out there that show if you do, you know, they're. They're going to support, you know, the strategy and patient experience gets better and, you know, the financials get better. So that's another area that, as we think about remaining viable and just thriving, is just making sure we've got a really healthy, happy workforce that feels valued. So that's another focus focus for us as well. I love that.

[A]

Kelly, thank you so much for joining us on the podcast today. This has been a really fun conversation, and I'm excited to keep the conversation going at our CEO CFO Roundtable in November. I know you're speaking there, and it'll be great to see you and just be able to share some of these insights live and in person.

[B]

Well, thank you so much, Laura, for your time. Much appreciated, Sam.